Individual provider Active NPI

Carlin Williams, M.D.

  • Vascular Surgery Physician
  • Charlottesville, VA
National Provider Identifier
1407084247
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101258238 Issued in VA
Practice address
1215 Lee St FL 2
Charlottesville, VA 22908-1617
Phone
(434) 243-1000
Fax
(434) 244-7551
NPI assigned
Jul 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 00000000000000000 DC
Vascular Surgery Physician 2086S0129X 0101258238 VA Primary

Addresses

Primary practice location

1215 Lee St FL 2
Charlottesville, VA 22908-1617

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170927000581 VA Practitioner - Vascular SurgeryPractitioner - General Surgery 3971877135 Reassigns benefits to 1 organization
I20211110000516 DC Practitioner - Vascular Surgery 3971877135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Loma Linda University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Physician Services IncGroup PAC ID 4284631540, 144 clinicians

Practice addresses (Care Compare)

11711 Livingston Rd
Fort Washington, MD 20744-5151
Phone (301) 310-6802

Hospital & facility affiliations

  • Adventist Healthcare Fort Washington Medical Ctr Hospital, Fort Washington, MD, CCN 210060
  • Adventist Healthcare White Oak Medical Center Hospital, Silver Spring, MD, CCN 210016
  • Luminis Health Doctors Community Medical Ctr, Inc Hospital, Lanham, MD, CCN 210051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00000000000000000DCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Physician Services, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Adventist Physician Services (Wah) Past Accepting new patients

Locations

10709 Indian Head Hwy
Ste D
Ft Washington, MD 20744
Phone (240) 493-9650

11711 Livingston Rd
Ft Washington, MD 20744
Phone (301) 203-2250

820 W Diamond Ave
Ste 500
Gaithersburg, MD 20878

820 W Diamond Ave
Gaithersburg, MD 20878
Phone (301) 315-3030

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1407084247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST FL 2",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229081617",
            "telephone_number": "434-243-1000",
            "fax_number": "434-244-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CARLIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "00000000000000000",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101258238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.